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转移性乳腺癌的非典型表现:胃出口梗阻和皮革胃

Atypical Presentation of Metastatic Breast Cancer: Gastric Outlet Obstruction and Linitis Plastica.

作者信息

Smith Riley L, Ross Cassidy, Patel Arpankumar

机构信息

Internal Medicine, Liberty University College of Osteopathic Medicine (LUCOM), Lynchburg, USA.

Internal Medicine, Kentucky College of Osteopathic Medicine, Pikeville, USA.

出版信息

Cureus. 2025 Mar 7;17(3):e80225. doi: 10.7759/cureus.80225. eCollection 2025 Mar.

DOI:10.7759/cureus.80225
PMID:40196098
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11973398/
Abstract

Linitis plastica (LP) is a rare stomach cancer that has a high mortality rate due to late presentation and limited available therapies. LP has a varied clinical presentation and can present at all stages. LP can be a primary or secondary neoplastic process. Rarely, it occurs secondary to breast cancer (BC). In this case report, we present an 88-year-old female patient who has a history of right breast ductal adenocarcinoma. She underwent chemoradiation eight years ago and was in remission when she presented with nausea, vomiting, weakness, and jaundice. During an endoscopic ultrasound and endoscopic retrograde cholangiopancreatography, multiple biopsies were taken of epigastric lymph nodes and the gastric wall. The biopsy showed metastatic BC, and the lymph nodes were positive for metastatic adenocarcinoma, resulting in a diagnosis of LP secondary to BC. Although difficult to diagnose, this case report details the need for a lower threshold of endoscopic evaluation in a patient with a history of BC. It also emphasizes the need for further research into potential treatment options.

摘要

皮革胃(LP)是一种罕见的胃癌,由于就诊晚和可用治疗方法有限,其死亡率很高。LP临床表现多样,可在各个阶段出现。LP可以是原发性或继发性肿瘤过程。很少见的是,它继发于乳腺癌(BC)。在本病例报告中,我们介绍了一位88岁的女性患者,她有右乳腺导管腺癌病史。八年前她接受了放化疗,在出现恶心、呕吐、虚弱和黄疸时病情处于缓解期。在内镜超声和内镜逆行胰胆管造影检查期间,对上腹淋巴结和胃壁进行了多次活检。活检显示为转移性BC,淋巴结转移性腺癌呈阳性,从而诊断为继发于BC的LP。尽管难以诊断,但本病例报告详细说明了对于有BC病史的患者,内镜评估的阈值应更低。它还强调了对潜在治疗方案进行进一步研究的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df7a/11973398/2d0f4616ff5a/cureus-0017-00000080225-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df7a/11973398/607be39d1a96/cureus-0017-00000080225-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df7a/11973398/2d0f4616ff5a/cureus-0017-00000080225-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df7a/11973398/607be39d1a96/cureus-0017-00000080225-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df7a/11973398/2d0f4616ff5a/cureus-0017-00000080225-i02.jpg

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本文引用的文献

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Linitis Plastica in a Patient With Previous Breast Cancer: Primary Gastric Cancer or Breast Cancer Metastases?一名既往有乳腺癌患者的皮革胃:原发性胃癌还是乳腺癌转移?
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2
The Genomic Signatures of Linitis Plastica Signal the Entrance into a New Era: Novel Approaches for Diagnosis and Treatment.Linitis Plastica 的基因组特征标志着进入一个新时代:用于诊断和治疗的新方法。
Int J Mol Sci. 2023 Sep 28;24(19):14680. doi: 10.3390/ijms241914680.
3
Gastric Linitis Plastica: Clinical Characteristics and Outcomes from the National Cancer Database.
胃弥漫大 B 细胞淋巴瘤:国家癌症数据库的临床特征和结局。
Anticancer Res. 2023 Apr;43(4):1543-1548. doi: 10.21873/anticanres.16303.
4
Diagnostic value of core needle biopsy for determining HER2 status in breast cancer, especially in the HER2-low population.核心针活检在乳腺癌中确定 HER2 状态的诊断价值,特别是在 HER2 低表达人群中。
Breast Cancer Res Treat. 2023 Jan;197(1):189-200. doi: 10.1007/s10549-022-06781-3. Epub 2022 Nov 8.
5
Breast Cancer Metastasis: Mechanisms and Therapeutic Implications.乳腺癌转移:机制与治疗意义。
Int J Mol Sci. 2022 Jun 18;23(12):6806. doi: 10.3390/ijms23126806.
6
Rare sites of breast cancer metastasis: a review.乳腺癌转移的罕见部位:综述
Transl Cancer Res. 2019 Oct;8(Suppl 5):S518-S552. doi: 10.21037/tcr.2019.07.24.
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